Modified External Ventricular Drainage in Pediatric Tuberculous Meningitis: Is It Possible to Avoid Ventriculoperitoneal Shunt Placement?

作者：Lin Jian; Zhang Nu; Sheng Hang song; Wang Mao de^*; Yin Bo; Lin Fen chun

来源：Pediatric Neurosurgery, 2011, 47(2): 108-112.

DOI：10.1159/000330540

• Tuberculous meningitis
• Hydrocephalus
• Outdoor ventricular drainage
• Ventriculoperitoneal shunt
• Children

Objective: Ventriculoperitoneal shunting is the current mainstay of treatment for children with tuberculous meningitis with hydrocephalus. However, ventriculoperitoneal shunting is highly associated with complications, and more importantly, long-term, indwelling shunt devices may adversely affect children's spirits and psychological health. Therefore, there is clearly a need to explore methods of CSF diversion to avoid ventriculoperitoneal shunting. Methods: We studied 6 cases of children with tuberculous meningitis with hydrocephalus in whom external drainage from the ventricle to the subcutaneous abdomen was adopted. Outcomes were assessed over a 6- to 9-month follow-up period based on improvements in radiological features, such as ventricular morphology, as well as the need for ventriculoperitoneal shunting and any complications. Results: The drainage tubes were removed in 4 cases 4-6 months after the modified external ventricular drainage surgery, and 2 patients went on to receive a ventriculoperitoneal shunt. All patients' CSF protein and cell counts returned to normal, and imaging showed improved ventricular morphology and no intracranial secondary infection. Conclusion: In our preliminary study, the modified ventricular drainage device can produce satisfactory outcomes and relatively safe effects and may help some patients to avoid ventriculoperitoneal shunt placement.

• 出版日期2011
• 单位西安交通大学; 温州医科大学